How do you get an abortion under occupation? For Palestinians, some of the barriers to reproductive care are very literal: checkpoints, committees, intelligence agencies. They are also ideological: Women deal with the violence of Israel as well as patriarchy within their own families, social groups, and political leadership.
How these different dynamics intersect and what they mean for women’s reproductive health and freedoms varies hugely across Palestine’s geography, where the occupation controls all Palestinian bodies through different but integrated structures and instruments. Women living under siege and frequent bombing in Gaza have different choices and approaches to abortion than women living in the West Bank, or Palestinian women with Israeli citizenship living in Tel Aviv or Haifa or al-Lydd.
Palestinians have been struggling for freedom and autonomy for a century, from the first Zionist settlements in the late 1800s, through the British mandate period and up to Israel’s present day colonial project. Women’s involvement in the struggle for liberation has been documented and popularized: Leila Khaled is an international icon of 1970s militancy, while stories of women launching surprise attacks on British soldiers in the night, sometimes while carrying children, are part of a regional memory of resistance. Women are always agents and leaders in popular political struggles; it’s because of the equally persistent control of women’s bodies and their often-violent domestication that this agency still carries an element of surprise.
To understand how abortion connects to other forms of struggle in Palestine, I spoke with a woman I’ll call J, a reproductive health advocate from East Jerusalem. She is from the neighborhood of Silwan, which sits on a ridge on the south side of the Mount of Olives, just a couple of minutes from the walls of Jerusalem’s Old City. It began as a farming village and was incorporated over time into the city’s urban networks. After the Israeli occupation in 1948, it came under Jordanian administration until Israel formally annexed it and the rest of East Jerusalem in 1967. J and other Palestinian Jerusalemites are not citizens of Israel, nor are they residents of the West Bank, which is administratively controlled by the Palestinian Authority. Instead, they hold an Israeli-issued “residency status” which permits them to live and work in Jerusalem, although it can be revoked at any time for a variety of reasons, including temporarily living anywhere else in the country. Meanwhile they continuously face home demolitions, evacuations, and all kinds of harassment as Israel builds, protects, and encourages Zionist settlement of Palestinian neighborhoods. Over the past decade, the encroachment on Silwan has included the construction of the nearby City of David, a sort of theme park of national mythology for Americans on Birthright and other tourists.
J works with an Israeli sexual and reproductive health organization, where she runs the Arabic counseling program for people seeking advice and support on reproductive health choices, including unwanted pregnancies. She also trains volunteers, runs educational workshops, and oversees the organization’s Arabic social media. In a place where most citizens serve in the occupying military, the tension and conflict between different kinds of feminism is central to J’s experience of her work at the organization. For safety from legal and professional reprisal, she requested that her identity be kept anonymous in this piece. We spoke on the phone in July. The conversation has been translated from Arabic and edited for clarity.
* * *
Yasmin El-Rifae Realistic options for abortion must be very different for women depending on where they live in Palestine. Can you tell me a bit about those differences and how you encounter them in your work?
J So when it comes to abortion, East Jerusalem operates under Israeli law, which means that women must go before committees to have their requests for abortion approved. [After the Dobbs decision in the U.S., Israeli regulations were changed so that committees can approve these applications digitally rather than in person.] There are some conditions for this, but really the vast majority of requests are approved. And with that approval, women are sometimes able to have the abortion covered by medical insurance.
But in reality, in East Jerusalem, access to medical care in general is complicated by language barriers. I speak Hebrew because I went to an Israeli university, but many Palestinian women in Jerusalem don’t, and they have a hard time dealing with the Israeli hospitals and clinics. So one of the things we do at the organization is send volunteers to accompany women and act as translators for them.
I once heard of a case of a 40-year-old woman who was pregnant and went to Hadasa [an Israeli hospital], and the social worker spoke no Arabic, and told her that she would have to go before this committee, and the woman was intimidated. So she got in touch with someone who told her she could have an abortion privately. She ended up in the E.R. at Hadasa, and she died because of a wound to her uterus. I heard about this story from nurses and social workers at the hospital and I will never forget it.
In the West Bank, abortion is illegal. So at the center we get requests from women all over Palestine, way beyond Jerusalem, because there aren’t really many organizations doing comparable work. Women sometimes come from the West Bank to get safe abortions at hospitals here, which they pay for privately.
YER How do they manage to come?
J Some people apply for permits to come to Jerusalem for this hospital care, but these can be very slow, and some people worry that if the reason for the permit is recorded in their files it will be used against them. So they sneak in.
If a woman is uninsured, as would be the case for anyone from the West Bank, a safe abortion costs around 6,000 Israeli Shekels [about $1,600] if performed before week 17 of the pregnancy. After that, it requires a hospital stay, which costs around 5,000 shekels per night in addition to the cost of the procedures. We try to raise money for women who can’t cover the costs. We do that a lot for Eritrean refugee women, for example.
YER What are the options for women seeking abortions within the West Bank?
J Pills are available on the black market in the West Bank. So women there will self-administer, and sometimes we consult with them on the phone, although we can’t provide the pills ourselves. Sometimes women from Jerusalem will go buy pills from Ramallah rather than seek the legal route, for many reasons. Not wanting the exposure, not wanting the abortion noted in their medical files.
In the southern parts of the country, and with bedouins, you have different issues around mobility. There are some Israeli hospitals in an-Naqab. But bedouin women face particular social pressures; they are more conservative. They must have dayas [traditional midwives] and other private ways of dealing with unwanted pregnancies.
YER How did you find your way to this work?
J I started volunteering with women’s rights and feminist groups in university, and one of the things that was very present and clear for me from a young age was how very little information and discussion there is over sexual and reproductive rights in Arabic in Jerusalem. As soon as I started doing workshops and meetings in Arabic on these topics, I knew this was where I wanted to be. I don’t think women can have any equality in any realm without control over their bodies. So even if it’s taboo, even if people look at you like you’re a scandal, it’s worth it for me.
YER How do you deal with conservatism around women’s sexual lives in your work?
J I didn’t want to be part of an Israeli organization at first. But I knew I didn’t have another way to work on paths to safe abortion because Israel controls these.
As Palestinian volunteers, we find it difficult but we know it’s necessary. The strategy of putting this issue aside “till later” doesn’t work. Whenever there is political conflict we always end up making women bear a bigger burden. We have this mentality of: “let us free ourselves from the occupier and then deal with sexual violence, with abortion.” It’s complicated. Palestinian women for example will have a great difficulty appealing to Israeli authorities in cases of sexual violence.
There isn’t enough conversation about the right to abortion in Palestinian communities here in East Jerusalem, we don’t even know about the Israeli committees. When the Dobbs decision happened, I saw it on the pages of feminist organizations but there wasn’t much conversation in real life. We are very careful about how we publicize our work on our social media pages. I feel like we’ve made some progress in talking a bit more openly about sexual violence and harassment, but when it comes to total
YER How does the occupation intersect with this conservatism when it comes to women’s bodies?
J Israel has demographic concerns, and I worry that the organization is seen as keeping Palestinian numbers low. There is a demographic dimension to the struggle. Some families do keep having babies for the struggle, to keep birthing resistance fighters. This is part of the political culture in some parts of
But one of the biggest pressures is religious: the question of is this haram, am I killing a baby, and so on. And sometimes women are also worried for their safety, worried about being attacked by men in their lives for the pregnancy or the abortion.
YER How do your personal politics interact with the rest of
J I went to an Israeli university, so I was always going to be part of an Israeli job market. For me, Palestine is historic Palestine, 1948 Palestine. Since I’m from East Jerusalem, for me this is a clear occupation, and Israel is obliged to provide us these services as the occupied people.
But it’s hard, of course. When [the journalist] Shireen Abu Akleh was killed, it was horrible to sit between [my colleagues] and go through watching that, with people who don’t understand it at all. Sometimes I feel like I’m suffocating. I am open about how difficult it is to sit across from white Israelis who face different struggles than me. Israelis portray us as oppressed and marginalized Arabs, and of course unfortunately this is true, but that’s not all I am or all we are and it’s not right to just portray us like that.
Which is more important to me, my Palestinian identity or my feminist identity? Do I have to make concessions to keep them?
But for me, despite these conflicts, it is worth it for what I can provide for women. I don’t want to see women dying, not having control. Sometimes I think I will open my own Palestinian association one day.
Yasmin El-Rifae works with the Palestine Festival of Literature, and is an editor at Lux. Her first book, Radius, published with Verso in 2022.
Photographs by Rob Stothard for The Palestine Festival of Literature.
Thank you to the Rosa Luxemburg Stiftung – New York Office and the German Ministry for Economic Cooperation and Development (BMZ) for their support of this article.